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Systemic Pharm > Hormones > Flashcards

Hormones Flashcards

1
Q

What are the four hormone therapies

A
  1. thyroid disease
  2. menopausal hormone therapy
  3. contraception
  4. selective estrogen receptor modulators (SERMS)
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2
Q

The thyroid gland governs tissue metabolism. What are the two major thyroid hormones

A
  1. triiodothyronine (T3)

2. thyroxine (T4)

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3
Q

Which type of thyroidism causes bradycardia, poor cold resistance, and mental/physical slowing and is associated with low hormone levels

A

hypothyroidism

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4
Q

which type of thyroidism cause tachycardia, body wasting, tremor, nervousness, and heat flashes

A

hyperthyroidism

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5
Q

what are the 3 drugs used to treat hypothyroidism

A
  1. levothyroxine
  2. levothroid
  3. liothyronine
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6
Q

what are the drugs used to treat hyperthyroidism

A
  1. propylthiouracil

2. methimazole

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7
Q

what is the #2 highest selling drug in america

A

levothyroxine sodium (synthroid)

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8
Q

which two drugs inhibit the first conversion step and the production of the hormone

A

propylthiouracil and methimazole

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9
Q

what is the MOA of levothyroxine

A

synthetic T4

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10
Q

what are common AE of levothyroxine

A
  1. weight loss
  2. diaphoresis (sweating a lot)
  3. headache
  4. alopecia
  5. hypertension
  6. pseudotumor cerebri aka intracranial hypertension –> kids can be seen with swollen optic nerves
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11
Q

what are ocular SE of levothyroxine

A

myasthenia gravis like symptoms: ptosis, diplopia, EOM paresis

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12
Q

what are drug interactions of levothyroxine

A
  1. sympathomimetics are additive

2. sympatholytics are antagonistic

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13
Q

what is the most potent estrogen produced and secreted by the ovary? what is the primary circulating estrogen after menopause?

A

estradiol; estrone (metabolite of estradiol)

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14
Q

what are the 4 therapies used in menopause

A
  1. estrone
  2. estradiol
  3. estrogen
  4. mestranol
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15
Q

what is the indication of estrone

A
  1. menopause
  2. breast cancer
  3. prostate cancer
  4. osteoporosis prevention
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16
Q

what is the MOA of estrone

A

binds to estrogen receptors, developing and maintaining female sex characteristics and reproductive systems

17
Q

what are common AE of estrone

A
  1. headache/migraine
  2. elevated BP
  3. weight changes
  4. fluid retention
  5. contact lens intolerance (impt!)
  6. vision changes
18
Q

What are black box warnings for estrone

A
  1. endometrial cancer
  2. invasive breast cancer
  3. stroke
  4. DVT
  5. MI
19
Q

what are drug interactions of estrone

A
  1. azole antifungals (impaired metabolism)
  2. adverse effects of systemic steroids may be increased
  3. anti hyperlipidemic effects of omega 3 FA’s may be antagonized. –> LDL levels are increased.
20
Q

what are contraindications of estrone

A
  1. hypertension
  2. smoker
  3. migraine with aura > without aura
21
Q

What are the drugs/therapies used for contraception

A
  1. drospirenone/ethinyl estradiol (YAZ)
  2. norgestimate-thinyl estradiol
  3. norethindrone- ethinyl estradiol
  4. medroxyprogesterone (progesterone)
22
Q

how is grouping of the contraceptions done?

A

by activity profile vs progesterone alone:

  • monophasic
  • biphasic
  • triphasic
  • four phasic
23
Q

what is the indication for Yaz

A
  1. contraception
  2. acne vulgaris
  3. dysmenorrhea
  4. endometriosis
  5. PCOS
24
Q

what is the MOA of Yaz

A

suppresses LH and FSH; inhibiting ovulation; alters cervical mucus and endometrium.

25
Q

what are common AE of Yaz

A
  1. headache
  2. weight changes
  3. BP elevated
  4. increased cholesterol
  5. contact lens intolerance
26
Q

what are severe AE of Yaz

A
  1. MI
  2. Stroke
  3. ocular lesions
27
Q

what is the BB warning for Yaz

A
  1. smoking

2. CV events

28
Q

What are drug interactions with Yaz

A
  1. impaired metabolism of cyclosporine
  2. NSAIDs: additive hyperkalemia
  3. Tetracyclines, Penicillins, cephalosporins, macrolides, and quinolones: decreased efficacy
  4. ascorbic acid (vitamin C): decreased metabolism
29
Q

what are contraindications of Yaz

A
  1. hypertension
  2. smoker
  3. migraine with aura > without aura
30
Q

What is the selective property of SERMS and what is their use?

A

refers to their ability to inhibit or stimulate estrogen receptors depending on the tissue. Uses include management of breast cancer, osteoporosis, menopause and anovulation (infertile woman)

31
Q

what is the most common SERM

A

tamoxifen

32
Q

what is the indication of tamoxifen

A

metastatic breast cancer

33
Q

what is the MOA of tamoxifen

A

binds to estrogen receptors, producing estrogenic and anti estrogenic effects

34
Q

what are common AE of tamoxifen

A
  1. dizziness
  2. headache
  3. VA changes
35
Q

what are severe AE of tamoxifen

A
  1. thromboembolism, stroke
  2. pancytopenia (declined cells in our body that are routinely replaced in our body)
  3. retinopathy, cataracts (impt!)
36
Q

what are drug interactions of tamoxifen

A
  1. may increase cyclosporine, systematic steroid, oxycodone levels
  2. chlorpheniramine (OTC AH), macrolides - inhibits hepatic production of active metabolite

Systemic Pharm (9 decks)

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